Individual
DELATRE LOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1901 1ST AVE, NEW YORK, NY 10029-7404
(212) 423-6771
Mailing address
14 RALEIGH DR, NEW CITY, NY 10956-5841
(845) 639-4126
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
210931
NY
Other
Enumeration date
11/21/2006
Last updated
07/08/2007
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